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Endoscopic Ultrasound-Guided Management of Pain in Chronic Pancreatitis and Pancreatic Cancer: an Update

  • Pancreas (V Chandrasekhara, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Purpose of review

Unrelenting pain from chronic pancreatitis (CP) and pancreatic cancer (PC) remain clinical challenges for the physician and a significant cause of decreased quality of life for the patient. Endoscopic ultrasound (EUS)-guided therapy for each condition is distinct and builds on the endosonographer’s straightforward access to the celiac axis.

Recent findings

Over the past 20 years, generally small studies of modest methodology have surfaced for both EUS-guided celiac plexus block (CPB) and celiac plexus neurolysis (CPN).

Summary

Our review aims to synthesize, analyze, and update the latest literature on the technique, efficacy, and safety of these procedures. EUS-CPB’s role in treating CP pain is likely still relevant for a subset of patients and studies have shown efficacy and safety. However, a dramatic drop in research publications on the topic will make optimizing its role (including technique, injectate, and patient selection) increasingly difficult. However, EUS-CPN for PC pain is actively being refined with new information, data, and even guidelines. New EUS-guided strategies to treat PC pain besides conventional neurolysis are also likely to evolve in coming years.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Division of Gastroenterology, Jewish General Hospital, McGill University, 3755 Cote Ste. Catherine, Montreal, QC, H3W2L2, Canada

    Jonathan M. Wyse MD, MSc. (Epid.)

  2. Division of Gastroenterology, Center Hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Anand V. Sahai MD, MSc. (Epid.)

Authors
  1. Jonathan M. Wyse MD, MSc. (Epid.)
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  2. Anand V. Sahai MD, MSc. (Epid.)
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Corresponding author

Correspondence to Jonathan M. Wyse MD, MSc. (Epid.).

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Conflict of Interest

Jonathan Wyse declares that he has no conflict of interest. Anand Sahai declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pancreas

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Wyse, J.M., Sahai, A.V. Endoscopic Ultrasound-Guided Management of Pain in Chronic Pancreatitis and Pancreatic Cancer: an Update. Curr Treat Options Gastro 16, 417–427 (2018). https://doi.org/10.1007/s11938-018-0193-z

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  • DOI: https://doi.org/10.1007/s11938-018-0193-z

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